Fludarabine

Fludarabine treats a certain type of blood cancer. It can lower your blood count and can increase the risk of an infection. Tell your doctor if you notice a fever.

Fludarabine Overview

Reviewed: November 7, 2012

Updated: March 27, 2018

Fludarabine is a prescription medication used to treat adult patients with a type of cancer called chronic lymphocytic leukemia. Fludarabine belongs to a group of drugs called antimetabolites. It works by interfering with cancer cell growth and reproduction.

This medication is available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

Fludarabine Precautions

Fludarabine can cause serious side effects, some of which can be life-threatening, including:

a decrease in the number of blood cells produced by the bone marrow, causing anemia, increased risk for infection, and increased risk of bleeding. Tell your doctor if you experience any of the following symptoms:

a serious or life-threatening reaction can occur if you receive a blood transfusion during or after fludarabine treatment. Tell your doctor if you are receiving or have received fludarabine injections before you receive a blood transfusion.

infertility (sterility) in women by interfering with the normal menstrual cycle, and in men by stopping the production of sperm

Do not take this medication if you are allergic to any ingredient in fludarabine.

Fludarabine Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of fludarabine there are no specific foods that you must exclude from your diet when receiving this medication.

Fludarabine and Pregnancy

Tell your healthcare provider if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Fludarabine falls into category D. It is not known if fludarabine will harm your unborn baby. Because fludarabine has the potential to harm your unborn baby, take precautions to avoid pregnancy during fludarabine therapy and for at least 6 months after treatments.

Tell your healthcare provider right away if you become pregnant while receiving this medication.

Fludarabine Usage

Fludarabine is a liquid to be infused (slowly injected into a vein) by a healthcare provider in a medical facility. The infusion lasts approximately 30 minutes and is given once daily for five days in a row. This cycle may be repeated every 28 days.

Your doctor will order certain tests to check your body's response to fludarabine.

Other Requirements

Fludarabine FDA Warning

Fludarabine for injection should be administered under the supervision of a qualified physician experienced in the use of antineoplastic therapy. Fludarabine for injection can severely suppress bone marrow function. When used at high doses in dose-ranging studies in patients with acute leukemia, fludarabine for injection was associated with severe neurologic effects, including blindness, coma, and death. This severe central nervous system toxicity occurred in 36% of patients treated with doses approximately four times greater (96 mg/m2/day for 5-7 days) than the recommended dose. Similar severe central nervous system toxicity, including coma, seizures, agitation and confusion, has been reported in patients treated at doses in the range of the dose recommended for chronic lymphocytic leukemia.

Instances of life-threatening and sometimes fatal autoimmune phenomena such as hemolytic anemia, autoimmune thrombocytopenia/thrombocytopenic purpura (ITP), Evan's syndrome, and acquired hemophilia have been reported to occur after one or more cycles of treatment with fludarabine for injection. Patients undergoing treatment with fludarabine for injection should be evaluated and closely monitored for hemolysis.

In a clinical investigation using fludarabine for injection in combination with pentostatin (deoxycoformycin) for the treatment of refractory chronic lymphocytic leukemia (CLL), there was an unacceptably high incidence of fatal pulmonary toxicity. Therefore, the use of fludarabine for injection in combination with pentostatin is not recommended.

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